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'9a2 BUILDING DEPARTMENT
BUILDING INSPECTOR
❑ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK
❑CODE ENFORCEMENT OFFICER 938 KING STREET • RYE BROOK,NY 10573
(914) 939-0668 FAx (914) 939-5801
www ryebrook.org
- - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - -
ADDRESS: 1 ` V <�A DATE:
PERMIT# �" ISSUED: SECT: BLOCK: LOT:
LOCATION: Ca QD(- Qr CaR � Koc CU CY: C-
❑ VIOLATION NOTED THE WORK IS... )31 ACCEPTED ❑ REJECTED/REINSPECTION
❑ SITE INSPECTION REQUIRED
❑ FOOTING
❑ FOOTING DRAINAGE
❑ FOUNDATION
❑ UNDERGROUND PLUMBING NOTES ON INSPECTION:
❑ ROUGH PLUMBING
❑ ROUGH FRAMING
❑ INSULATION
❑ NATURAL GAS �� Io�� U(� \ t , \ 1 c
❑ L.P.GAS
❑ FUEL TANK
❑ FIRE SPRINKLER
❑ FINAL PLUMBING
❑ CROSS CONNECTION
INAL
❑ OTHER
1
BUILD TMENT
VILL OF RY OOI{ Initial Inspection Date: ❑ Pass
MICHAEL J.IzzO 938 KING ST RYE BROO , Ew YORK 10573 `—L 1 Fail
BUILDING&FIRE INSPECTOR (914)9 939-5801 Re-Inspection Date: ❑ Pass
inizzoaa.rvebrook.org c>r`��
❑ Fail
FIRE INSPECTION REPORT, NOTICE OF VIOLATION & ORDER TO REMEDY SAME 2
Site Address: v� 1 n ak �� Zone:�_� SBL:
Occupancy: k t Y J e Use Classification:
Business Owner: ' ` Phone:
Building Owner: , 1 # 1 Phone: `t
Emergency Contact: las C 7'1 Phone:
Building Representative in Attendance: i D
- ----------------------------------------------------------------------------------------------------------------------------=----------------------------------------
Take notice that the following violations of tWwYork S to Uniform FirePrevention&Building Code and/or the Code of the
Village of Ry Bro were found to exist at, `j�T ,in the Village of Rye Brook,
�
NY on, �] \ -LC�?-- 2he i2e son enttl served with this Order to Remedy must completely cure
each violation described in this Order to Remedy by �.�L ,which is thirty(30)days after the date of this Order
to Remedy.You are further directed to contact the Buildi g Department during normal business hours to schedule a re-inspection of
the premises to confirm full compliance with all applicable codes, laws,rules®ulations.
BE ADVISED THAT YOUR FAILURE TO CORRECT ALL VIOLATIONS IS A CRIME PUNISHABLE BY FINE,IMPRISONMENT OR BOTH..
---------------------------------------------------------------------------------------------------------------------------------------------------------------------
No YES N/A
1,PORTABLE FIRE EXTINGUISHERS (PFE's)
a.906.1.'Are;PFE's installed throughout the space&on the premises as required by code. a. �
b.906.3.1. Is the maximum travel distance to a PFE 75 feet or less. b.
c.906.5.Aye PFE's conspicuously located&readily accessible. C._
d.906.6.Are PFE's unobstructed/unobscured from view. d._ _✓ _
e.906.7.Are PFE's properly mounted as per the manufacturers instructions. e._ Jell _
f.906.9.Are PFE's properly installed:<40 lbs.max.5' above floor;>40 lbs.max.3.5'above floor. f._ .
2.FIRE ALARM SYSTEM&SMOKE DETECTORS
A.901.6.1. Is the fire alarm system inspected,tested&maintained in accordance with NFPA 72.
b.907.4.2.1.Are manual pull stations located within 5 feet of exits&within 200 feet of each other.
c.907.4.2.2. Is the height of the pull station handle located between 42&48 inches above the floor. C.
d:907.3. Is a fire alarm system provided in existing buildings as per section 907.3.1 &907.3.2. d._
3.FIRE SUPPRESSION SPRINKLER SYSTEM&FIRE HYDRANTS
a.901.6.1. Is the sprinkler system inspected,tested&maintained in accordance with NFPA 25-13. a._ ✓� _
b.901.6.1.Are the main valves secured against tampering in the open position. b. ✓
c.901.6.1.Are sufficient clearances maintained from fire sprinkler heads to fixtures or materials. C.
d.901.6.1. Is a supply of six spare heads&a wrench maintained on the premises. d.
e.901.6.1.Are sprinkler heads&cover plates unfinished or of factory applied finish only. e._ _v_
f.901.6.3.Are records of all system inspections,tests&maintenance reports maintained on the premises. f._
g.913.5.Is the fire pump inspected,tested&maintained in accordance with this section&NFPA 25. g. ✓
h.507.5.2. Is the fire hydrant system properly maintained,operational,compatible w/NST&tested annually. h._ i✓
i.507.5.4.Are fire hydrants&fire protection equipment unobstructed. i._ —
j.507.5.5.Is a clear space of not less that 3 feet maintained around all hydrants. j.— _
k.901.8.Are all fire protection syste place and maintained mpered. k.V4
— t/
INSPECTOR: DATE:
-1- t
` Revised 6/11/2020
No YEs N/A
4.STANDPIPE.CABINETS&FIRE DEPARTMENT CONNECTIONS
a.901.6.1. Is the standpipe system inspected,tested&maintained in accordance with NFPA 25-14. a. _ _✓ _
b.901.6.1. Has the required flow test been performed within the past 5 years as per NFPA 25-14. b. _ l/
c.912.2.3 Are standpipe FDC threads compatible with fire department standards. C.
d.905.7.Are cabinets containing fire fighting equipment unobstructed/unobscured. d.
e.905.7.1.Are cabinets containing fire fighting equipment properly identified&labeled. e. ✓ _
f.912.2.1.Are exterior FDC's fully visible&recognizable from the point of fire department access. f
g.912.4.Are all FDC's unobstructed and available for immediate access by the fire department. g.
5.EXITS,MEANS OF EGRESS&OCCUPANCY -
a. 1031.2.Are exits&exit enclosures continuously maintained free from obstructions or impediments. a.
b. 1031.3. Is the means of egress free from obstructions including accumulated ice&snow. b.
c. 1031.6.Are exits maintained unobstructed by furnishings,decorations,draperies,mirrors,etc... C.
d. 1031.7.Are existing emergency escape&rescue openings maintained as per this section. d.
e. l 010.1.Are egress doors provided and maintained as required by this section. e.
f. 1004.9.Are all spaces having an assembly occupancy posted with an approved occupant load sign. f.
g. 1013.1.Are exits marked by a properly located,approved&readily visible exit sign. g.
h. 1013.1. Is the maximum travel distance to any exit sign in an exit access corridor 100 feet or less. h.
i. 1013.4. Are tactile exit signs complying with ICC/ANSI 117.1.provided as required by code. i.
j. 1013.3.Are all exit signs illuminated at all times. J. _ V/1 _
k.1008.1.Are the means of egress&exit discharge illuminated at all times the building is occupied. k. _
1. 1018.3.Are public aisles in group B&M occupancies maintained at least 36"wide where fixtures
- are placed on one side of the aisle&at 44"wide where fixtures are placed on both sides.
m. 1018.3.Are non-public/non-accessible aisles serving less than 50 people maintained at least m.
28"wide,or at least 36"wide where serving 50 or more people.
6.COMBUSTIBLE STORAGE&WASTE MATERIALS
a.304.1. Is the building(s)and premises maintained free from accumulated combustible waste material. a. _ '001 _
b.304.1.2. Is property free from weeds,grass,vines or other growth capable of being ignited. b.
c.304.2. Is combustible rubbish stored so as not to create a nuisance or hazard to the public. C. _
d.315.3.Are combustible materials properly stored&separated from ignition sources. d. _ r/
e.315.3.1. Is storage maintained 24"or more below the ceiling in nonsprinklered buildings, e. _ t/
and 18"or more below sprinkler head deflectors in sprinklered buildings.
f.315.3.2.Are exits&exit enclosures maintained free from stored combustible materials. f
g.315.3.3.Are boiler,mechanical&electrical rooms maintained free from stored combustible material. g.
h.313.1. Is building maintained free from stored fueled equipment.(motorcycles,mopeds, mowers,etc...) h.
7.ELECTRICAL
a.604.1. Is the building free from modified/damaged wiring,devices,appliances,equipment a.
and maintained free from electrical hazards.
b.604.2.Are electrical service equipment areas properly illuminated. b.
c.604.3. Are proper working space clearances provided&maintained for electrical service equipment. C. u
d.604.3.Are electrical service equipment working spaces free from any stored materials. d. le
e.604.3.1.Are all electrical control panel room doors,panel boards&disconnects properly labeled. e._ ✓ _
f.604.4.Is the building free from unfused multi-plug electrical adapters. f. _ _v
g.604.5.Are electrical extension cords being used in a safe manner as per code. g. _ J�
h. 604.6.Are all junction,switch&outlet boxes fitted with approved covers or plates. h. _
i.604.6.Is the building free from open-wiring spliced electrical connections. i.
j.604.8.Are electrical motors maintained free from accumulated oil,dirt& debris. j.—
k.915.1. Are Carbon Monoxide Detectors installed&maintained as required by this section and by 1103.9. k._
121Gt�Z�--
INSPECTOR: DATE:
-2-
Revised 6/11/2020
No YES N/A
8.ELEVATORS,DUMBWAITERS&ESCALATORS
a. [PMl 603.1.Are elevators properly maintained,and is the current certificate of inspection on the premises. a.
b. 606.3.Are approved standardized,pictorial signs posted adjacent to each elevator call station on all b.
floors reading; IN FIRE EMERGENCY,Do NOT USE ELEVATOR,USE EXIT STAIRS
c.606.7.Are keys for elevator car doors&fire department service kept in an approved location. C.
d.315.3.3.Are elevator machine rooms maintained free from stored combustible material. d.
e. [B]3005.1.Are elevator machine room doors maintained unobstructed at all times. e.
9.COMMERCIAL KITCHENS
a.906.1. Are portable Class K fire extinguishers installed within 30 feet of cooking equipment. a.
b. 904.12.5.Is the fire protection equipment inspected,tested&maintained as per Section 901.6. b.
c.904.12.5.2. Are automatic fire extinguishing systems serviced at least every 6 months&after system C.
activation,and is the certificate of inspection forwarded to the code enforcement official.
d.904.12.5.3.Are fusible links&automatic sprinkler heads replaced annually. d.
10.HEATING SYSTEMS
a. [PM]603.1.Are all heating appliances properly installed&maintained in a safe working condition. a. _
b. [PM]603.2.Are all fuel-burning appliances&equipment connected to an approved chimney or vent. b.
c. [PMl 603.3.Are heating appliances maintained with proper clearances from combustible material. C.
d. [PM]603.4.Are safety controls for fuel-burning equipment maintained in effective operation. d.
e. [PMl 603.5.Is the fuel-burning equipment provided with adequate combustion&ventilation air. e.
11.MOTOR FUEL-DISPENSING FACILITIES&REPAIR GARAGES
a.2303.2. Is an approved, labeled&readily accessible emergency disconnect switch provided a.
in an approved location within 100' of,but not less than 20' from fuel dispensers.
b.2304.3.4.Are dispenser operating instructions conspicuously posted on every fuel dispenser. b.
c. 2304.2.4. Are fuel-dispensers unobstructed&in clear view of the attendant at all times. C.
d.2305.5.Are approved portable fire extinguishers complying with Section 906 with a minimum rating of d.
2-A:20-B:C provided&located not more than 75' from pumps,dispensers&fill-pipe openings.
e.2305.6.Are warning signs provided&posted within sight of each dispenser as per this section. e.
f. 2305.7.Are weeds and other combustible materials kept at least 10' from fuel-handling equipment. f.
g.2306.4.Are above-ground tanks provided with vehicle impact protection. g-
h.2306.5.Are above-ground tanks provided with secondary spill containment. h.
12.HAZARDOUS MATERIALS(HAZ-MATS)
c. 407.2.Are S.D.S. Sheets for all haz-mats readily available on the premises. a.
d. 407.3.Are spaces and individual containers containing haz-mats properly labeled&identified. b.
e. 5004.2.Are stored haz-mats provided with approved secondary spill containment. C.
d. 5003.7.1. Are proper No SMOKING signs provided as per this section. d.
13.MISCELLANEOUS
a.403.1. Is an approved fire safety&evacuation plan prepared& maintained for the building/occupancy. a. _
b.405.1.Are emergency evacuation drills conducted at the intervals as specified in Table 405.2. b.
c.405.5.Are records of emergency evacuation drills kept&maintained on the premises. C.
d. 505.1.Are approved address&building numbers properly placed&plainly visible from the street. d.
e. 506.1.Are approved key boxes(knox boxes)provided,properly located&equipped with the proper keys. e.
f. 703.1. Is all required fire-resistance rated construction properly maintained as per code. f,
g. 703.1.Are openings through fire-resistance rated assemblies properly protected&maintained. g.
h.5303.5.Are compressed gas cylinders&systems secured &safeguarded against damage&access. h.
i. 5303.6.1.Are compressed gas cylinder caps or collars in place at all times except when tanks are in use. i.
14.GENERAL HoU5kKEEPING
a.Good _
b. Fair
c.Inadequate
d. Poor
INSPECTOR: DATE:
-3-
Revised 6/11/2020
ITEM NUMBER -Als\-Z-)- REMARKS
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INSPECTOR: DATE: 1�, `C�` -��
-4-
Revised 6/11/2020
Automatic Sprinkler Systems Calculated Fire Protection Co., Inc.
2510 Route 44, Suite 2
General Information Salt Point, NY 12578
(Office) 845.677.5201 (Fax) 845.677.5208
Date:11-9-22 Inspector: Mike Baines System: Wet
Location: CPW Center, 1186 King Street, Ryebrook, NY 10573
General
System designation Wet
Building CPW Center
Location of sprinkler valve 1 st floor classroom
Type of sprinkler system ❑AF ❑✓ Wet ❑ Dry ❑Deluge ❑Preaction
Make and model of sprinkler valve Riser Check Valve
Is building fully sprinklered? ❑✓ Yes ❑No
Is entire sprinkler system in service? ❑✓ Yes ❑No
Has sprinkler system been modified since last inspection? ❑ Yes ❑✓ No OWNER MUST VERIFY
Valves
How are valves supervised? ❑Seated ❑ Locked Tamper switch
Are valves indentified with signs? Yes ❑No
Water Supply
When was last water supply test made? 8.3.22
Are reservoirs, tanks, or pressure tanks in good condition? ❑✓ Yes ❑No ❑NA
Pumps N/A
Is fire pump ❑ Diesel ❑ Electric ❑Gasoline ❑None?
When was pump last inspected?
Is pump in good condition? ❑Yes ❑No
Fire Department Connections
Location Bldg. Front
Are identification signs provided? ✓❑ Yes ❑ No
Wet Systems
Is building adequately heated? ✓❑ Yes ❑No
Is system hydraulically calculated? ✓❑ Yes ❑No
If yes, is hydraulic information sign provided at valve? ❑✓ Yes ❑No
Dry Systems N/A
Is dry pipe valve in heated room? ❑ Yes ❑No
Does heated room have low-temperature alarm? ❑ Yes ❑No
Deluge System N/A
Preaction System N/A
Notes This inspection is not intended to reveal Installation flaws or code compliance violations. It
Is intended to ensure that It is in operation and all components are functioning properly. It is assumed
that this system met code at the time of installation.
Last known date of periodically required inspection:
5 Year Standpipe Flow Test: 10 Year Dry Head Test:
3 Year Full Trip Test: 10 Year Quick Response Follow Up Test:
5 Year Internal Obstruction Investigation: 20 Year Quick Response Head Test:
Full Visual:
Calculated Fire Protection Co., Inc.
2510 Route 44, Suite 2
Salt Point, NY 12578
(Office) 845.677.5201 (Fax) 845.677.5208
Automatic Sprinkler Systems
Quarterly Inspection and Tests
Year: 2022 System: Wet
Location: CPW Center, 1186 King Street, Ryebrook, NY 10573
Y=Satisfactory N=Unsatisfactory(explain below)
Date 11-9-22 111-9- 2
Inspector Mike Baines IMB
Main Drain Test YES NO N/A
Record the static water supply pressure in psi(bar)as indicated on the lower pressure gauge. 100 ❑ ❑
Open the main drain and allow water flow to stabilize.
Record the residual water supply pressure while water is flowing from the z-in.(51-mm)
main drain as indicated on the lower pressure gauge in psi(bar). 55 ❑ ❑
Close the main drain(slowly).
Fire Department Connections
Verify connection is visible and accessible, not damaged,caps or plugs are in place,identifica- ❑✓ ❑ ❑
tion sign is in place, and automatic drain is working properly.
Wet Pipe System Flow Alarm
Test water-flow alarms by opening the inspectors test valve. (Notify alarm company to avoid ✓❑ ❑ ❑
false alarms.) 32 seconds
Dry Pipe Priming Level
Check dry priming water level by opening the test valve and checking for a small amount of ❑ ❑ ❑✓
water to discharge. If no water flows out of the test line,add priming water.
Dry Pipe System Low-Air-Pressure Alarm
Close the water supply valve and carefully open inspector's test valve to reduce air pressure
slowly.(Do not reduce air pressure sufficiently to trip the dry pipe valve.)Confirm operation of ❑ ❑ ❑✓
low-pressure alarm, record air pressure at which low-pressure alarm activated,close inspector
test, allow air pressure to rise to normal,then open water supply valve.PSI:
Dry Pipe System Flow Alarm El ❑ El
the alarm bypass valve.(Notify alarm company to avoid false alarms.)
Quick-Opening Device ❑ El ❑
Test in accordance with manufacturers instructions.
Preaction System Flow Alarm El ❑ El
the alarm bypass valve.(Notify alarm company to avoid false alarms.)
Deluge System Flow Alarm ❑ ❑ El
the alarm bypass valve. (Notify alarm company to avoid false alarms.)
Control Valves El El El
valves and reopen until spring or tension is felt—back valve 1/4 turn.
Hydraulic Nameplate
If system was hydraulically calculated,assure nameplate is legible and securely attached ❑✓ ❑ ❑
to riser.
Notes
Record any notes about the system that the inspector believes to be significant. Place a num-
ber in this block and number the corresponding note on the reverse of this form.
NOTES:- Residual water flow much lower than previous tests, bldg. engineer states this may be due to work that
was recently done on underground valve.
Manual for
Non-public School Facility
Fire and Building Safety Inspections
�11IV ERSI?5
6
v r
f 791
The University of the State of New York
The State Education Department
Office of Facilities Planning
Room 1060 - Education Building Annex
Albany, New York 12234
www.pl2.nysed.gov/facplan
REVISED
October 2020
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Page l ofl5
Table of Contents
Introduction ..................................................................................................................3
SUBMISSIONPROCESS..............................................................................................3
I. Legal Foundations..................................................................................................4
NewYork State Law............................................................................................4
Regulations of the New York State Commissioner of Education .........................4
2020 Fire and Building Codes of New York State................................................4
II. Inspector Qualifications.........................................................................................4
FIRE SAFETY INSPECTION PROCESS.......................................................................5
I. Documentation of Annual Inspection Request..........................................................5
and Explanation of Denial (as needed).....................................................................5
II. The Inspection Process.............................................................................................5
III. The Post-Inspection Process....................................................................................6
Notice of non-conformances to fire department (as needed) ...................................6
IV. Providing Public Notice of Inspections......................................................................6
THE FIRE AND BUILDING SAFETY INSPECTION REPORT......................................7
I. General Information, History and drill reporting info..................................................7
II. Fire-Safety Inspection Non-Conformance Code Reference Checklist .................8-14
III. Certifications........................................................................................................... 15
Page 2 of 15
Introduction
This manual provides guidance for New York State non-public school authorities and code
enforcement officials pertaining to the requirements for annual fire and building safety
inspections of non-public school facilities.
The intent of the annual inspection is to verify that buildings comply with State Education Law,
the regulations of the Commissioner of Education, and applicable sections of the New York State
Uniform Fire Prevention and Building Code.
Step-by-step instructions for the planning, inspection, post inspection, and documentation
requirements are included in this manual. This document has been updated to reflect
significant changes in the submission process for annual fire reports to the New York
State Education Department (NYSED), The requirements in this manual are in conformance
with the 2020 Fire Code of New York State, 2020 Building Code of New York State and the
2020 Property Maintenance Code of New York State (effective May 12, 2020).
NOTE: Only non-public school student-occupied facilities must be inspected (classroom
buildings, dining halls, dormitories, etc.)
SUBMISSION PROCESS
• All non-public schools are required to annually submit the results of the fire and building safety
inspections to the NYSED Office of Facilities Planning. This year the submission process is being
allowed electronically via the NYSED Application Business Portal. The Portal is protected from
unauthorized use with secure user IDs and passwords. See: http://portal.nysed.gov
• The new reporting process includes an annual requirement that all non-public schools verify the
ownership and use of all buildings they occupy as documented within the portal. If there are
additional buildings owned & occupied by the non-public school how will this be handled?
• Updated Certificates of Occupancy must be obtained from the local code enforcement office and
posted as required. Non-public schools fall under the building code jurisdiction of the local municipal
code enforcement office.
•The revised 2020 Nonpublic Fire and Building Safety Inspection Report is available on our website:
http://www.pl2.nvsed.gov/facplan/FireSafety/fire safety report homepage.html
Reminder: using the NYED Application Business Portal is the preferred method of submission;
original paper copies will still be accepted by mailing them to The State Office or Religious and
Independent Schools (SORIS)
The submission of the fire safety report, described herein and required by Education Law 807-a,
does not apply to private schools with less than 25 students or schools located in the cities of New
York, Buffalo, Rochester, Syracuse and Yonkers. In those cities and locations private schools shall
conduct fire inspections and file reports with the city or local code authority in accordance with Title
19 NYCRR Chapter XXII and local regulations.
Page 3 of']5
I. Legal Foundations
New York State Law
New York State Education Law Section 807-a states that it is the duty of nonpublic school
authorities to cause buildings for student use to be inspected at least annually for fire hazards
which may endanger the lives of students, teachers and employees therein. The report shall be
filed with the Commissioner of Education. Section 807-a was amended, effective February 15,
2020 and this revised manual reflects all revisions enacted and included in S-4663--B.
Reaulations of the New York State Commissioner of Education
While most requirements included within the New York State Commissioner of Education
Regulation 8 NYCRR Part 155 apply only to public schools and boards of cooperative
educational services (BOCES), Section 155.25 applies to all schools including nonpublic and
charter schools.
• 155.25 Safety Requirements for Electrically Operated Partitions
Regulation related to electrically operated partitions, room dividers, and curtains.
2020 Fire and Building Codes of New York State (effective May 12, 2020) The applicable
provisions of this code are 19 NYCRR Part 1221, 2020 Building Code of New York State, 19
NYCRR Part 1225, 2020 Fire Code of New York State, and Part 1226, 2020 Property
Maintenance Code of New York State. The online version of the code is available on the New
York State Department of State - Division of Building Standards and Codes website:
hops://www.dos.ny.gov/dcea/
II. Inspector Qualifications
This annual inspection must be conducted to verify that each student occupied building complies
with New York State Education Law Section 807-a, select Commissioner's regulations, and
applicable sections of the New York State Uniform Fire Prevention and Building Code.
School authorities shall cause any fire inspection per Education Law Section 807-a to be made
by one of the following methods or any combination of such methods:
• Requesting inspection by the fire department of any city, town, village, or fire district in which the
building is located.
• Requesting inspection by a fire corporation that is subject to the provisions of Section 1402 of
the not-for-profit corporation law, if such building is located within the area described in the
certificate of incorporation of any such corporation.
• Requesting inspection by the county fire coordinator, or the officer performing the powers and
duties of a county fire coordinator pursuant to the local law, of the county in which the building
is located, or by any deputy county fire coordinatoror deputy if such other officer so performing
the powers and duties of a county fire coordinator, if the building is located outside a city, town,
village, or fire district, which has its own fire department and outside the area described in the
certificate of incorporation of any fire corporation that is subject to the provisions of Section 1402
of the not-for-profit law.
• Requesting inspection by a fire inspector, who holds a valid certification.
UPDATED Page 4 of 15
October 2020
FIRE SAFETY INSPECTION PROCESS
New York State Education Law Section 807-(a)(1) requires inspections for nonpublic school
buildings containing classroom(s), dormitory, laboratory, physical education, dining, or
recreational facilities for student use. New York State Education Law Section 807a requires that
regardless of the method used to accomplish the inspection, the authority making the inspection
shall file the report with school authorities no later than the first day of December each year.
I. Documentation of Annual Insaection request & exi2lanation of denial (as needed)
In accordance with State Education Law Section 807-a (revised) paragraph 3 (b) After
having been requested to do so, if any fire department, certified fire inspector or fire
corporation shall fail or refuse to make a fire safety inspection promptly, the request shall
be denied in writing to the school authorities; with an explanation of why such request was
denied. In no event, may an authority(otherwise required by law to conduct fire inspections
within a municipality) or a county fire coordinator, refuse a request by a school authority for
such inspection.
II. The Inspection Process
a) School officials must complete Part I of the Fire and Building Safety Report
annually.
b) Inspectors must be provided with a copy of previous year's inspection report.
c) Inspectors must provide the results of the current year's inspection to school officials
for Part II of the Fire Safety Report.
• The inspector should use "Appendix C— Fire Safety Inspection Code Reference Checklist"
for each building as the inspection is conducted.
• It is strongly recommended that a school administrator or their designee accompany the
inspector.
• Nonconformances discovered during the inspection represent violations of the minimum
standards of fire and building safety required by the 2020 Fire Code of New York State, the
2020 Property Maintenance Code of New York State, and Section 155.25 of the Regulations of
the Commissioner of Education.The inspector is to record all nonconformances on the School Fire
Safety Nonconformance Reporting Sheet.
• The inspector is to record all nonconformances for each violation observed. Wherever
possible, all such violations shall be corrected immediately. The inspector shall give the
school official a list of locations of non conformances.
UPDATED Page S of!S
October 2020
III. The Post-Inspection Process
ALL nonconformances (deficiencies) shall be promptly remedied. The remedy for some
nonconformances may involve structural modifications or services of outside vendors.
Clearly such matters may require time to correct, however these nonconformances still
violate the minimum standards for the fire and building safety and must be corrected without
undue delay.
Pursuant to State Education Law, Section 807-a 5 (e), if the report shows any alleged
deficiencies or non-conformances, the school authorities shall provide the details of such
deficiencies to the local government that administers and enforces the Uniform Fire
Prevention and Building Code for the municipality in which the building is located.
IV. Providing Public Notice of Inspections
In accordance with Education Law, Section 807-a 5 (b) and (c), within 20 days of filing the
report with the State Education Department, school authorities shall cause public notice of
the filing of the report to be given in substantially the following form:
"Notice is hereby given that the annual inspection for... (year)of the ... school building (or of
the ... and ... school buildings) of(name of nonpublic school) for fire hazards which might
endanger the lives of students, teachers, employees therein, has been completed and the
report thereof is available at the office of (nonpublic school) at ... for inspection by all
interested persons."
If the inspection was not made by the local fire department responsible for fire protection of
the building, a copy of such notice shall be mailed to the chief of that fire
department/company.
The school authorities shall cause such notice to be published on the school's website
or at least once in a newspaper having general circulation in the postal area in which the
school is located. If there is no newspaper having general circulation in the postal area, the
school authorities shall post notice in ten conspicuous places in the postal area. Proof of
posting or publication of such notice and the mailing of a copy of such notice to the fire chief
shall be filed in the school's office.
UPDATED Page 6 of l5
October 2020
THE FIRE AND BUILDING SAFETY INSPECTION REPORT
The Manual for Non-public School Facility Fire and Building Safety Inspections is available
on the State Education Department's Office of Facilities Planning web site at:
www.pl2.nysed.gov/facplan. It is also available at: www.pl2.nysed.gov/nonpub.
Appendix C of this manual, the Fire Safety Inspection Code Reference Checklist, shall be
used as a reference during the inspections.
Part I — General Information and Fire/Life Safety History
This section must be completed annually.
Part II-B: Non-public Fire Safety Non-Conformance Report Sheet
This section must be completed annually by all non-public schools.
Part III: Non-public Certifications
This section applies to all inspected buildings. The administrator, director, or headmaster must
be aware that in signing the report, they are certifying that:
Public notice of report availability has been published, and that:
c Any non-conformances noted as corrected on this report were corrected, and that;
o For uncorrected nonconformances that appear on this report, the school authorities, shall
provide the details of such deficiencies to the local government that administers and enforces
the uniform fire prevention and building code for the municipality in which the building is located.
UPDATED Page 7 of 15
October 2020
Appendix C - Fire and Building Safety Inspection Code Reference Checklist
Part II — Fire and Life Safety Standards
Section II — B
Commissioner of Education Regulations (8 NYCRR 155.25)
8. Electrically Operated Partition if N/A or electrically disconnected and locked out —go to Section 9
Code/Points Description
Partitions are operated by two key operated, tamperproof, constant
A-2 pressure, switches wired in series, remotely located at opposite ends and
opposite sides of, and in view of, the partition.
B-2 The partition is capable of being reversed at any point in the extend or stack
travel cycle.
Device(s)are provided for all partitions that will stop the forward or backward
motion of the partition and stop the stacking motion of the partition when a
C-2 body or object passes between the leading panel of such partition and a wall
or other termination point, or when a body or object is in the stacking area
of such partition.
Appropriate and conspicuous notice regarding the safe and proper
D-2 operation of the electrically operated partition, required training, and
su ervision of students is posted in all partition operator locations.
Records of inspection, testing, and maintenance of electrically operated
E-2 partitions are available for review. Records verify that maintenance was
performed in accordance with the manufacturer's instructions and
recommended service interval.
2020 Fire Code of New York State
9. General Fire and Safety Provisions
Code/Points Description Code Section
A-2 Combustible waste and vegetation shall not create a hazard F304
B 2 Open flames are prohibited except in supervised science and technology F308.2
labs
C-1 Storage in buildings in orderly. F315
Storage ceiling clearance of 24 inches is maintained in non-sprinklered
D-1 areas of buildings or 18 inches below sprinkler head deflectors in F315
sprinklered areas of the building
F-2 Combustibles are not stored in boiler rooms, mechanical rooms,or F315
electrical equipment rooms.
G-2 Fueled equipment shall not be stored, operated or repaired within a F313
building.
UPDATED Page 8 of!5
October 2020
10. Emergency P anning and Preparedness
Code/Points Description Code
Section
A-2 Fire safety and evacuation plans are prepared, maintained, and available F403
for review. F404
B-2 Safety Data Sheets (SDS) are complete and available on premises. F407
C-1 Hazardous material containers and rooms are properly identified. F407
D-1 Records of hazardous material inventory statements are provided. F407
11. Fire Service Features
Points Description Code
Section
A-2 Fire apparatus access roads are maintained and unobstructed. F503
NOTE: Gates arepermitted)
B-1 Flat roofs, less than 30 degrees, are free from obstruction. F316
C-2 Private fire service hydrants, mains, and tanks are properly maintained and F507
tested.
D-2 Fire hydrants are maintained free from obstruction. F507
E-1 Fire protection equipment and locations are identified and maintained. F509
12. uilding Services and Systems
Points Description Code
Section
A-1 Equipment access is maintained. F603
B-3 Portable unvented heaters are prohibited F603
C-2 Above-ground gas meters are protected from damage. F603
D-2 Records of inspection, testing, and maintenance of emergency and standby F1203
power systems are maintained on premises and are available for inspection.
E-1 No electrical system hazards observed or reported. F604
F-1 Service equipment areas are adequately illuminated. F604
G-1 Electrical service and branch equipment working space is unobstructed. F604
H-1 Electrical room doors and all disconnects are identified. F604
1-1 Unapproved multi-plug adapters are not used. F604
J-1 Extension cords are properly used; not a substitute for permanent wiring. F604
K-1 Outlet, switch, junction boxes, and wire splices are covered. F604
L-1 Refrigeration systems are accessible, properly labeled, and records of F605
periodic testing are available on premises.
UPDATED Page 9 oJ'I S
October 2020
12. Building Services and Systems (con't.)
Non- Code
Conformance Description Section
Points
M-1 Approved elevator emergency signs are provided. F606
N-1 Emergency elevator keys are properly located in an approved location F606
for immediate use by the fire department.
Heating equipment, chimneys, and vents are maintained and are in
0-2 proper F603
working order.
13. Commercial Kitchen Hoods
code/points Description Code
Section
A-2 Kitchen hood is provided and maintained at commercially used equipment F607
ca able of producing grease vapors or smoke.
B-2 Hood fire extinguishing system, where provided, is maintained and serviced F607
in accordance with Section F904 of the 2015 IFC.
14. Fire Resistance Rated Construction
code/points Description Code
Section
A-2 Fire resistance rating of rated construction is maintained. F703
B-2 Opening protectives are properly maintained and are not blocked or F704
made inoperable.
Doors requiring closers are not rendered inoperable by removal of the
C-2 closer of the installation of an non-automatic hold open device. F705
Records of annual inspections of sliding and rolling fire doors are
D-1 available. F705
E-1 Swinging fire & smoke doors close AND latch automatically from any F705
position
15. Decorative Material and Furnishing
Code/points Description Code
Section
A-2 Furnishings do not obstruct or obscure exits. F807
B-1 Storage of clothing and personal belongings in corridors and lobbies is F807
compliant
C-2 Artwork and teaching materials are limited to not more than 20% of the F807
corridor wall area.
Curtains, drapes, hangings, and other decorative materials suspended
D-2 from walls or ceiling shall comply with Section 807.4 and shall not F807
exceed 10% of the specific wall or ceiling to which they are attached
Artwork and teaching materials in classrooms limited to not more than
E-1 50% of the specific wall area to which the are attached F807
UPDATED Page IO o/I
October 2020
16. Fire Protection Systems
code/points Description Code Section
Fire detection, alarm, and extinguishing systems are operative; and
A-2 inspection, testing, and maintenance records are maintained and available F901
for review on premises.
Portable fire extinguishers are located in a conspicuous location, are
B-2 readily accessible, are not obstructed or obscured, and are maintained in F906
accordance with this section and NFPA.
C-2 Fire pumps are inspected, tested, and maintained in accordance with this F913
section and NFPA 25 and records are available on premises for review.
Carbon Monoxide detection and alarm systems are operative and
D-2 maintained in accordance with Code; and records are available for review F915
on premises.
17. Means of E ress
Code/points Description Code Section
A-3 The required capacity of means of egress is free of obstructions. F1031
B-2 Exterior exits are free from obstruction, including ice and snow. F1031
C-2 Curtains, drapes, and decorations shall not be placed to obstruct exits or
F1031
visibility thereof.
D-2 Exit signs are provided in rooms or areas which require two or more exits. F1013
E-1 Exit sign placement shall be such that no point in an exit access corridor F1013
is more than 100 feet from the nearest visible exit sign.
Doors shall be readily operable from the egress side without use of a key
F-3 or special knowledge or effort. Electromagnetic locking devices are not PM702.3
allowed.
G-1 Occupant load is conspicuously posted in all assembly spaces where F1004
occupant load exceeds 49 persons.
H-2 Means of egress are provided with emergency lighting. F1104.5
1-2 Tactile signs stating "EXIT' and complying with ICC/ANSI, A117.1 are F1013
rovided adjacent to each door to an egress stairway. _
Aisles are provided in all occupied spaces containing seats, tables,
J-1 furnishings, displays, and similar fixtures of equipment and are F1104.23
unobstructed at all times.
K-1 Stairways that travel below the level of exit discharge are clearly defined. F1104.21
L-1 Required exit signs are provided with emergency illumination. 01104.3
18. Flammable Finishes
Code/points Description Code Section
A-2 Electrical wiring and equipment in spray areas shall be explosion proof. F2403
B-2 "No Welding" signs shall be posted in the vicinity of the paint spraying F2403
areas and paint storage areas.
C-2 Portable fire extinguishers rated for high hazard shall be provided in paint F2404
spraying areas.
D-2 Spraying areas, exhaust fan blades, and exhaust ducts shall be kept free F2403
from the accumulation of deposits of combustible residues.
UPDATED Page 11 of 15
October 2020
19. Motor Fuel- Dispensing Facilities & Repair Garages
Code/points Description Code Section
An approved, clearly identified and readily accessible emergency
A-3 disconnect switch shall be provided for fuel dispensers and distinctly F2303
labeled "Emergency Fuel Shutoff."
Approved fire extinguishers, with a minimum rating of 2-A: 20-B:C, shall
B-2 be located within 75 feet of pumps, dispensers, and storage tanks. F2305
C-1 Approved warning signs shall be posted in the fuel dispensing area. F2305
D-1 Daily inventory records are maintained for underground fuel storage tanks. F2306
E-1 Above-ground tanks are protected from impact by motor vehicles. F2306
F-1 Sources of ignition shall not be located within 18 inches of the floor in F2311
repair garages.
G-1 Appropriately rated fire extinguishers are provided in repair garages. F2311
A non-coin operated telephone or other means to notify the fire
H-2 department is provided on-site. F2304
20. elding and Other Hot Work
Code/points Description Code Section
A-1 Hot work is conducted in areas designed or authorized for that work. F3501
B-1 Combustible materials are protected to prevent ignition. F3504
Fire extinguishers with a minimum 2-A:20-B:C ratings are located within
C-1 30 feet of hot work area. F3504
21. Hazardous Materials
Code/points Description Code Section
The storage, use & handling of all hazardous materials are in accordance
A-3 with Fire Code Section 5003. F5003
22. Com ressed Gases
Code/points Description Code Section
A-3 Compressed gas containers are marked in accordance with CGA C-7. F5303
B-3 Compressed gas containers are secured and protected. F5303
C-3 Protective caps, plugs, or devices are in place. F5303
UPDATED Page 12 of 15
October 2020
23.2020 Pro pert Maintenance Code of New York State
Code/points Description Code Section
Required equipment systems, devices, and safeguards are maintained in
A-1 ood workingorder. PM106
B-1 Non-required equipment, devices, and systems are maintained in good PM106
workinq order or removed.
C-1 All exterior property and premises shall be maintained in a clean, safe, PM302
and sanitary condition.
D-2 Certificate of elevator inspection is available for review. PM606
24. Unsafe Structures and Equipment
An unsafe structure is one that is found to be dangerous to life, health, property, or safety of the
public or the occupants of the structure by not providing minimum safeguards to protect or warn
occupants in the event of fire, or because such structure contains unsafe equipment or is so
damaged, decayed, dilapidated, structurally unsafe, or of such faulty construction or unstable
foundation, that partial or complete collapse is possible.
Unsafe equipment includes any boiler, heating equipment, elevator, moving stairway, electrical
wiring or device, flammable liquid containers or other equipment on the premises or within the
structure which is in such disrepair or condition that such equipment is a hazard to life, health,
property, or safety of the public or occupants of the premises or structure.
non-conformance code/points Description Code Section
If, in the opinion of the inspector, the building or
equipment is deemed unsafe, as described above,
or unfit, unlawful or dangerous for occupancy per
the conditions described in 2020 Property
Maintenance Code of New York State Section 107;
A-3 such structure shall be condemned, and the PM107
inspector shall check this item on the
nonconformance sheet, provide a written
explanation of the hazard, and IMMEDIATELY
contact the New York State Education Department
Office of Facilities Planning at 518-474-3906.
UPDATED Page 13 of 15
October 2020
25.Vacant Premises
Code/points Description Code Section
Temporarily unoccupied buildings, structures, premises or portions F311.1.1
A-1 thereof, including tenant spaces, shall be safeguarded and maintained. through
311.6
Vacant structures and premises thereof or vacant land shall be maintained
B-1 in a clean, safe, secure and sanitary condition. PM301.3
C-1 Exterior Property Areas and premises shall be maintained in a clean, safe, PM302
secure and sanitary condition.
26. Other Requirements
non-conformance
codes/points Description Code Section
Document violations of any provisions of the 2020 Fire Inspector to cite the
Code of New York State that are not specifically called out specific code section
A-3 on this form. List the section number of each code to identify the
requirement detailing the specifics of the violation. deficiency or
non-conformance
UPDATED Page 14 of 15
October 2020
Certifications — Part III — Nonpublic Schools
Description
Section III-A: Fire Inspection Method
Section III-B: Fire Inspection by Local Fire Department Fire Corp or County Fire
Coordinator or Fire Inspector who holds a Valid Certification
• Inspector's Name and Title
• Inspector's Organization
• Telephone Number
• Inspector's Email
• Inspector's Registry# (assigned by the NYS Department of State)
Section III-C: School or Building Administrator Director, or Headmaster
• Name
• Title
• Telephone Number
• Email
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�►' documentation of the inspection. Whenever discrepancies exist between acceptable performance
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Executive Summary
Generated by:BuildingReports.com
Building Information
Building: Cerebral Palsy of Westchester Contact: Dan Graham
Address: 1 186 King Street& Lincoln Phone: 914-384-4060
Address: Fax:
City/State/ZIP Code: Purchase, NY 10577 Mobile:
Country: United States of America Email:
Inspection Performed By
Company: ADT Commercial LLC Inspector: Chad Burgess
Address: Red Hawk Fire & Security Phone: 914-3434633
Address: 6 Skyline Dr. Fax:
City/State/ZIP Code: Hawthorne, NY 10532 Mobile:
Country: United States of America Email: chad.burgess@redhawkus.com
System Control Unit
Manufacturer: Edwards Inspection Date: 08/25/2022 IDC Style: B
Model Number: EST 3 Install Date: 01/31/2007 SLC Style: 4
Software Version: 4.0 Version Date: 05/16/2011 NAC Style: Y
Location: 1 st FACP Control Room Current Protection: Breaker
Company:Statewide Phone: 888-388-6436 Account#:
Type: Digital Communicator Mfg: Silent Knight Model#: 5104
Test Time/Date: Restore Time: Note:
ADT Commercial LLC 1 Download Date: 11/09/2022
Inspection Summary
Category Total Items Serviced Passed Failed/Other
Qty % Qty % Qty % Qty %
Auxiliary 8 4.23% 0 0.00% 0 0.00% 0 0.00%
Control 11 5.82% 9 81.82% 2 22.22% 7 77.78%
Initiating 166 87.83% 1 0.60% 1 100.00% 0 0.00%
Sound Test 1 0.53% 0 0.00% 0 0.00% 0 0.00%
Supervisory 3 1.59% 3 100.00% 3 100.00% 0 0.00%
Totals 189 100% 13 6.88% 6 46.15% 7 53.85%
Certification
Company:ADT Commercial LLC Building:Cerebral Palsy of Westchester
Inspector:Chad Burgess Contact: Dan Graham
ADT Commercial LLC 2 Download Date: 11/09/2022
Discrepancy Report
Generated by:BuildingReports.com
uilding: Cerebral Palsy of sestchester oritrol Panel: l - Edwards. ES_T 3
The Discrepancy Report consolidates each discrepancy listed within the various Testing sections of your Inspection.
Discrepancies are listed by Category, and grouped by device type. The description of the problem is provided and where
appropriate, code references are listed for your convenience.Any item that was inspected that is subject to a recall or part
Of a manufacturer's re lacementl; adep oq ram is included.
evic, Manufacturer ModelNumber
Items listed for Recall or Replacement/Upgrade
No items found during this inspection.
"al Location 4 Problem Address Q Reference
Control
Battery
360661 30 1 st A Wing Mechanical Room l
36066131 1 st A Wing Mechanical Room 1
30665370 1 st Booster Panel 1
30665371 1 st Booster Panel l
30665369 1 st Communication Panel 1
30665255 1 st MAIN FACP t
36066534 1 st MAIN FACP 1
ADT Commercial LLC 3 Download Date: 11/09/2022
Proposed Solutions Report
Generated by: BuildingReports.cont
Building: Cerebral Palsy of Westchester Control Panel: 1 - Edwards EST 3
The Proposed Solution Report provides a solution for each discrepancy listed on the Discrepancy Report. Provide a
check mark where indicated to approve repairs listed within the report. Items listed as TIM are available for repair on a
Time and Materials basis.
ScanlD Location Solution Model # Cost Fix
Control
Battery
360661 30 1 st A Wing Mechanical Room Replace ISO9002 T/M ❑
360661 31 1 st A Wing Mechanical Room Replace ISO9002 T/M ❑
30665370 1 st Booster Panel Replace ISO9001 T/M ❑
30665371 1 st Booster Panel Replace ISO9001 T/M ❑
30665369 1 st Communication Panel Replace BW1280 T/M ❑
30665255 1 st MAIN FACP Replace BW12220 T/M ❑
36066534 1 st MAIN FACP Replace BW12220 T/M ❑
PO*: (none) T/M
ADT Commercial LLC 4 Download Date: 11/09/2022
Inspection & Testing
Generated by: BuildingReports.com
Building: Cerebral Palsy of Westchester Control Panel: 1 Edwards EST 3
The Inspection& Testing section lists all of the items inspected in your building. Items are grouped by Passed or
Failed/Other. Items are listed by Category. Each item includes the services performed, and the time& date at which
testing occurred.
Device Type Location Service Time Date
Passed
Control
Control Panel 1 st FACP Control Room Tested 11:30:10 AM 08/25/2022
Expander Panel 1 st A Wing Inside Mechanical Room Tested 11:31:50 AM 08/25/2022
Initiating
Waterflow Switch 1 st B Wing Inside Sprinkler Room/ Room 19 Tested 11:07:56 AM 08/2S/2022
Supervisory
Tamper Switch 1 st B Wing Inside Sprinkler Room/ Room 19 Tested 1 1:08:12 AM 08/25/2022
Tamper Switch 1 st B Wing Inside Sprinkler Room/ Room 19 Tested 11:10:23 AM 08/25/2022
Tamper Switch 1 st B Wing Inside Sprinkler Room/ Room 19 Tested 11:11:43 AM 08/25/2022
Device Type Location Service Time Date
Failed/Other
Control
Battery 1 st A Wing Mechanical Room Tested 12:03:08 PM 08/25/2022
Battery 1 st A Wing Mechanical Room Tested 12:03:15 PM 08/25/2022
Battery 1 st Booster Panel Tested 12:03:31 PM 08/25/2022
Battery 1 st Booster Panel Tested 12:03:41 PM 08/25/2022
Battery 1 st Communication Panel Tested 11:31:19 AM 08/25/2022
Battery 1 st MAIN FACP Tested 11:30:47 AM 08/25/2022
Battery 1 st MAIN FACP Tested 11:30:54 AM 08/25/2022
Device Type Location Service Time I Date;�'X
Untested
Auxiliary
Releasing Device 1 st Corridor Nexr to Bathroom 3
Releasing Device 1 st Corridor Nexr to Bathroom 3
Releasing Device 1 st B Wing by A-1 Classroom
Releasing Device 1 st B Wing by A-1 Classroom
Releasing Device 1 st B Wing by Maintenance Offiice
Releasing Device 1 st B Wing by Maintenance Offiice
Releasing Device 1 st Corridor by Personal Care Room 2
Releasing Device 1 st Corridor by Personal Care Room 2
Control
Communicator 1 st Electric Room
Power Supply 1 st Electrical Room
Initiating
ADT Commercial LLC 5 Download Date: 11/09/2022
evice Type Location Service Time Date
Untested _
Duct Detector 1 st A Wing Mechanical Room A/C 5
Duct Detector 1 st B Wing Mechanical Room
Duct Detector 1 st C Wing Boiler Room
Duct Detector 1 st C Wing Fan Room A/C 3 Gym
Duct Detector 1 st C Wing Fan Room A/C 4 Gym
Heat Detector 1 st B Wing Classroom A 1
Heat Detector 1 st B Wing Classroom S-4
Heat Detector 1 st B Wing Electrical/ Fire Panel Room
Heat Detector 1 st B Wing Fire Panel Room
Heat Detector 1 st B Wing Front Reception
Heat Detector 1 st B Wing Janitors Closet/ Electrical Room Near
Exit
Heat Detector 1 st B Wing Men's/Women's Bathroom
Heat Detector 1 st B Wing Mens Bathroom 13
Heat Detector 1 st B Wing Women Bathroom 12
Heat Detector 1 st B Wing boiler Room
Heat Detector 1 st B Wing Bathroom 11
Heat Detector 1 st B Wing Bathroom 14
Heat Detector 1 st B Wing Janitors Closet
Heat Detector 1 st Bathroom WOMAN'S
Heat Detector 1 st Bathroom 15 MENS
Heat Detector 1 st Bathroom 7 MEN
Heat Detector 1 st C Wing Bathroom 9
Heat Detector 1 st C Wing Bathroom Women
Heat Detector 1 st C Wing Executive Office
Heat Detector 1 st C Wing Laundry Room
Heat Detector 1 st C Wing Men's Bathroom 2
Heat Detector 1 st C Wing Men's Room
Heat Detector 1 st C Wing Recreation Room / Gym Closet
Heat Detector 1 st C Wing Vestiblue Door 4
Heat Detector 1 st C Wing Women's Bathroom
Heat Detector 1 st C Wing Women's Bathroom 1
Heat Detector 1 st C Wing Bathroom
Heat Detector 1 st C Wing Boiler Room
Heat Detector 1 st Conference Room
Pull Station 1 st A Wing Workshop Exit
Pull Station 1 st A Wing Staff Lounge
Pull Station 1st B Wing Exit By Classroom 13
Pull Station 1st B Wing Exit By Office Offices&Therapies
Pull Station 1 st B Wing Exit By Water Electrical Room
Pull Station 1 st B Wing Main Entry Office&Therapies
Pull Station 1st B Wing Outside Bathroom 8
Pull Station 1 st B Wing office&therapy side exit
Pull Station 1 st C Wing Gym Entrance
Pull Station 1 st C Wing Gym Rear Exit Left
Pull Station 1 st C Wing Gym Rear Exit Right
Pull Station 1 st C Wing Gymnasium Entrance
Pull Station 1 st C Wing Main entrance
Pull Station 1 st C Wing Outside Care Room 3
Pull Station 1 st C Wing Outside Exploring Nature Office
ADT Commercial LLC 6 Download Date: 11/09/2022
Device Type Location Service Time Date
Untested
Pull Station 1 st C Wing Outside Supply Closet
Pull Station 1 st Cleaner Storage Room
Smoke Detector 1 st Gym storage 2
Smoke Detector 1 st Gym storage 3
Smoke Detector 1 st A Wing Cafeteria
Smoke Detector 1 st A Wing Corridor By Mechanical Room
Smoke Detector 1 st A Wing Corridor By Room 17
Smoke Detector 1 st A Wing Corridor By School Kitchen
Smoke Detector 1 st A Wing Corridor Outside Bathroom 19
Smoke Detector 1 st A Wing Corridor Outside Room 18
Smoke Detector 1 st A Wing Inside Classroom 14
Smoke Detector 1 st A Wing Inside Classroom 15
Smoke Detector 1 st A Wing Inside Classroom 16
Smoke Detector 1 st A Wing Inside Classroom 17
Smoke Detector 1 st A Wing Inside Classroom 18
Smoke Detector 1 st A Wing Inside Tech Center
Smoke Detector 1 st A Wing Inside Workshop Area
Smoke Detector 1 st A Wing Inside Workshop Area
Smoke Detector 1 st A Wing Inside Workshop Area
Smoke Detector 1 st A Wing Inside Workshop Area
Smoke Detector 1 st A Wing Inside Workshop Area Cypress Room
Smoke Detector 1 st A Wing Inside Workshop Area Cypress Room
Smoke Detector 1 st A Wing Inside Workshop Area Near Exit
Smoke Detector 1 st A Wing OT/PT Offiice
Smoke Detector 1 st A Wing Recreation Office
Smoke Detector 1 st A Wing ceiling hallway Corridor outside
bathroom 3
Smoke Detector 1 st B Wing Corridor By 13
Smoke Detector 1 st B Wing Corridor By Classroom 15
Smoke Detector 1 st B Wing Corridor By Daycare Room 5
Smoke Detector 1 st B Wing Corridor By Multi Purpose Room
Smoke Detector 1 st B Wing Corridor By Office 6
Smoke Detector 1 st B Wing Corridor By Room14
Smoke Detector 1 st B Wing Corridor Outside Maintenance Office
Smoke Detector 1 st B Wing Corridor Outside Mechanical Room
Smoke Detector 1 st B Wing Exit by Water Electric Room
Smoke Detector 1 st B Wing Inside Mechanical Room
Smoke Detector 1 st B Wing Inside 4
Smoke Detector 1 st B Wing Inside Classroom 16
Smoke Detector 1 st B Wing Inside Classroom 17
Smoke Detector 1 st B Wing Inside Classroom 18
Smoke Detector 1 st B Wing Inside Classroom S-4
Smoke Detector 1 st B Wing Inside Classroom S-5
Smoke Detector 1 st B Wing Inside Maintenance Office
Smoke Detector 1 st B Wing Inside Nurse Office 7
Smoke Detector 1 st B Wing Inside Speech Pathology
Smoke Detector 1 st B Wing Inside Sprinkler Room 19
Smoke Detector 1 st B Wing Office 1
Smoke Detector 1 st B Wing Office 6
Smoke Detector 1 st B Wing Outside Offices&Therapies
ADT Commercial LLC 7 Download Date: 11/09/2022
Device Type Location Service Time Date
Untested
Smoke Detector 1 st B Wing Social Workers Office 2
Smoke Detector 1 st B Wing Storage Room#6
Smoke Detector 1 st B Wing Storage Room 8
Smoke Detector 1 st B Wing Therapy Room
Smoke Detector 1 st B Wing care Room 5
Smoke Detector 1 st C Wing By Main Entrance
Smoke Detector 1 st C Wing Care Room 1
Smoke Detector 1 st C Wing Care Room 2
Smoke Detector 1 st C Wing Corridor Outside Classroom 1
Smoke Detector 1 st C Wing Corridor Outside Classroom 10
Smoke Detector 1 st C Wing Corridor Outside Classroom 12
Smoke Detector 1 st C Wing Corridor Outside Classroom 4
Smoke Detector 1 st C Wing Corridor Outside Classroom 5
Smoke Detector 1 st C Wing Corridor Reception Area
Smoke Detector 1 st C Wing Directors Office Conference Room
Smoke Detector 1 st C Wing Inside Care Room 3
Smoke Detector 1 st C Wing Inside Classroom 1
Smoke Detector 1 st C Wing Inside Classroom 10
Smoke Detector 1 st C Wing Inside Classroom 11
Smoke Detector 1 st C Wing Inside Classroom 12
Smoke Detector 1 st C Wing Inside Classroom 2
Smoke Detector 1 st C Wing Inside Classroom 3
Smoke Detector 1 st C Wing Inside Classroom 4
Smoke Detector 1 st C Wing Inside Classroom 5
Smoke Detector 1 st C Wing Inside Classroom 6
Smoke Detector 1 st C Wing Inside Classroom 7
Smoke Detector 1 st C Wing Inside Classroom 8
Smoke Detector 1 st C Wing Inside Classroom 9
Smoke Detector 1 st C Wing Inside Fan Room
Smoke Detector 1 st C Wing Inside Financial 5
Smoke Detector 1 st C Wing Inside Financial 6
Smoke Detector 1 st C Wing Inside Financial Office 3
Smoke Detector 1 st C Wing Inside Gymnasium Area
Smoke Detector 1 st C Wing Inside Gymnasium Area
Smoke Detector 1 st C Wing Inside Gymnasium Area
Smoke Detector 1 st C Wing Inside Gymnasium Area
Smoke Detector 1 st C Wing Inside IT Office
Smoke Detector 1 st C Wing Inside Janitors Closet 1
Smoke Detector 1 st C Wing Inside Janitors Closet 2
Smoke Detector 1 st C Wing Inside Nurses office 1
Smoke Detector 1 st C Wing Inside Nursing Office 2
Smoke Detector 1 st C Wing Inside Office 1
Smoke Detector 1 st C Wing Inside Office 10
Smoke Detector 1 st C Wing Inside Office 11
Smoke Detector 1 st C Wing Inside Office 12
Smoke Detector 1 st C Wing Inside Office 13
Smoke Detector 1 st C Wing Inside Office 2
Smoke Detector 1 st C Wing Inside Office 7
Smoke Detector 1 st C Wing Inside Office 8
Smoke Detector 1 st C Wing Inside Office 9
ADT Commercial LLC 8 Download Date: 11/09/2022
Device Type Location Service Time Date
Untested
Smoke Detector 1 st C Wing Inside Personal Care Room 4
Smoke Detector 1 st C Wing Inside Records Office
Smoke Detector 1 st C Wing Inside Supply Closet
Smoke Detector 1 st C Wing Inside office 4
Smoke Detector 1 st C Wing OUTSIDE BOILER ROOM
Smoke Detector 1 st C Wing Outside Janitors Closet 2
Smoke Detector 1 st C Wing Outside Office 11
Smoke Detector 1 st C Wing Outside Office 4
Smoke Detector 1 st C Wing Outside Office 6A
Smoke Detector 1 st C Wing Outside Office 9
Smoke Detector 1 st C Wing Outside Supply Closet
Smoke Detector 1 st C Wing Positioning Room 6A
Smoke Detector 1 st C Wing Corridor O/S Staff Lounge
Smoke Detector 1 st GYMNASIUM storage 1
Smoke Detector 1 st Hallway Corridor Outside Classroom 8
Smoke Detector 1 st Inside Nurses Offiice
Smoke Detector 1 st B Wing Office 5
ADT Commercial LLC 9 Download Date: 11/09/2022
Service Summary
Generated by.-BuildingReports.com
Building Cerebral L sy of Westchester
The Service Summary section provides an overview of the services performed in this report.
evice Typ ice, Quantity
A.
Failed/Other
Battery Tested 7
Total 7
Passed
Control Panel Tested 1
Expander Panel Tested 1
Tamper Switch Tested 3
WaterFlow Switch Tested 1
Total 6
Untested
Communicator 1
Duct Detector 5
Heat Detector 29
Power Supply 1
Pull Station 17
Releasing Device g
Smoke Detector 114
Total 175
Grand Total 1 gg
ADT Commercial LLC 10 Download Date: 11/09/2022
Auxiliary Functions Testing
Generated by: BuildingReports.com
Building: Cerebral Palsy of Westchester Control Panel: 1 - Edwards EST 3
The Auxiliary Functions Testing section lists each of the ancillary items, systems, and emergency equipment that are
controlled by the system control unit. Items are grouped by Passed or Failed/Other. The items are listed by device type,
and a check box is provided to indicate if the test conducted was simulated.
Tyl ;'Location comment ScanlD Simulated
Untested
Releasing Device
Door Holder 1 st Corridor Nexr to Bathroom 3 40320680 ❑
Door Holder 1 st Corridor Nexr to Bathroom 3 40320681 ❑
Door Holder 1 st B Wing by A-1 Classroom 40320674 ❑
Door Holder 1 st B Wing by A-1 Classroom 40320675 ❑
Door Holder 1 st B Wing by Maintenance Offiice 40320676 ❑
Door Holder 1 st B Wing by Maintenance Offiice 40320677 ❑
Door Holder 1 st Corridor by Personal Care Room 2 40320678 ❑
Door Holder 1 st Corridor by Personal Care Room 2 40320679 ❑
Smoke Detector
Smoke Compartment 1 st C Wing OUTSIDE BOILER ROOM 30665281
Smoke Compartment 1 st GYMNASIUM storage 1 30665271
ADT Commercial LLC 11 Download Date: 11/09/2022
Sound and Visual Testing
Generated by BuildingReports.com
LB
wilding: Cerebra aay of es_c ester ..
The Sound and Visual Testing section lists various points throughout your building where audible and visual alai-in
notification devices were tested. Any bar-coded audible and visual devices will appear in the Inspection and Testing
section of this report. Items in this section are grouped by Passed or FailedlOther. Where specific decibel readings were
recorded, they will appear under the ambient and alarm columns. The Voice column indicates whether the Sound Test
Point assed the Voice Intelligibility requirements. The STI or Sound Trans,nission Index is shown i recorded.
Ambient Alarm Intelli i A i
a
g ty
Location � Comment 4 dB 4 dB Voice STI Test
Untested
Sou
nd d Test Points
1 st Floor ❑ 0001
ADT Commercial LLC 12 Download Date: 11/09/2022
Smoke Management Testing
Generated by: BuildingReports.com
uilding: Cerebral Palsy of Westchester Control Panel: 1 - Edwards EST 3
i
The Smoke Management Testing section details the test and inspection of device items that are involved in controlling the
spread of smoke in a building. Items are grouped by Passed or Failedl Other.
0 Location Description r comment ScanlD Simulated
i
Untested
Releasing Device
1 st Corridor Nexr to Bathroom 3 Door Holder 40320680 ❑
1 st Corridor Nexr to Bathroom 3 Door Holder 40320681 ❑
1 st B Wing by A-1 Classroom Door Holder 40320674 ❑
1 st B Wing by A-1 Classroom Door Holder 40320675 ❑
1 st B Wing by Maintenance Offiice Door Holder 40320676 ❑
1 st B Wing by Maintenance Offiice Door Holder 40320677 ❑
1 st Corridor by Personal Care Room 2 Door Holder 40320678 ❑
1 st Corridor by Personal Care Room 2 Door Holder 40320679 ❑
ADT Commercial LLC 13 Download Date: 11/09/2022
Battery & Power Supply Testing
Generated by: BuildingReports.com
Building: Cerebral Palsy of Westchester Control Panel: 1 - Edwards EST 3
The Battery& Power Supply Testing section details the readings and measurements of batteries and power supplies used
to provide power to the fire alarm and life safety systems. Items are grouped by Passed or Failed/Other.
Battery
Rated Rated Pre Post Min Tested
Type Location Ah Volts Test Test Ah Ah
Failed/Other
Sealed Lead Acid 1 st A Wing Mechanical Room 7amp 12v
Sealed Lead Acid 1 st A Wing Mechanical Room 7amp 12v
Sealed Lead Acid 1 st Booster Panel 7amp 12v
Sealed Lead Acid 1 st Booster Panel 7amp 12v
Sealed Lead Acid 1 st Communication Panel 8 12
Sealed Lead Acid 1 st MAIN FACP 22 12v
Sealed Lead Acid 1 st MAIN FACP 22amp 12v
ADT Commercial LLC 14 Download Date: 11/09/2022
Inventory & Warranty Report
Generated by: BuildingReports.com
Building: Cerebral Palsy of Westchester Control Panel: 1 - Edwards EST 3]
The Inventory& Warranty Report lists each of the devices and items that are included in your Inspection Report. A
complete inventory count by device type and category is provided. Items installed within the last 90 days, within the last
year, and devices installed for two years or more are grouped together for easy reference.
Category % of Inventory Quanti.
Battery' Control 3.70% 7
Communicator Control 0.53% 1
Control Panel Control 0.53% 1
Duct Detector Initiating 2.65% 5
Expander Panel Control 0.53% 1
Heat Detector Initiating 1 5.34% 29
Power Supply Control 0.53% 1
Pull Station Initiating 8.99% 17
Releasing Device Auxiliary 4.23% 8
Smoke Detector Initiating 60.32% 114
Sound Test Sound Test 0.53% 1
Tamper Switch Supervisory 1.59% 3
Waterflow Switch Initiating 0.53% 1
Qty Model # Description Install Date
In Service - 3 Years to 5 Years
Bright way group
Battery 2 BW1 2220 Sealed Lead Acid 03/01/2019
Ultra Tech
Battery 2 IS09001 Sealed Lead Acid 11/05/201 8
Battery 2 IS09002 Sealed Lead Acid 11/05/201 8
In Service - 5 Years to 10 Years
Bright way Group
Battery 1 BW1 280 Sealed Lead Acid 1 1/01/201 7
EST
Duct Detector 5 SIGA-PS Photoelectric 05/15/2014
Heat Detector 29 SIGA-HRS Fixed Temperature 05/15/2014
Pull Station 17 270-SPO Single Action 05/15/2014
Smoke Detector 114 SIGA-PS Photoelectric 05/15/2014
Edwards
Releasing Device 8 1 508-AQN5 Door Holder 05/15/2014
Silent Knight
Expander Panel 1 5495 05/15/2014
System Sensor
Tamper Switch 2 OSY2 03/1 5/2013
Waterflow Switch 1 WFD30-2 03/1 5/2013
Victaulic
ADT Commercial LLC 15 Download Date: 11/09/2022
Tamper Switch 1 705 03/15/2013
In Service - 15 Years to 25 Years
Edwards
Control Panel 1 EST 3 01/31/2007
Power Supply 1 BPS 10 01/31/2007
Silent Knight
Communicator 1 5104 Digital Communicator 01/16/2006
ADT Commercial LLC 16 Download Date: 11/09/2022
Zone Address Report
Generated by BuildingReports.com
wilding: Cerebral Palsy of Westchester Control Panel: 1 - Edwards EST 3
The Zone Address Report lists all of the devices and items that have an individual address, or are grouped together under
a common zone. The device type, location, and description are included for your reference.
Address I Device Type Location Type ScanlD
Zone/Circuit: 01
0034 Heat Detector 1 st B Wing Bathroom 1 1 Fixed Temperature 30665247
0066 Heat Detector 1 st Bathroom 7 MEN Fixed Temperature 30665322
Zone/Circuit: 1
Expander Panel 1 st A Wing Inside Mechanical Room 36066132
Zone/Circuit: 02
0002 Smoke Detector 1 st B Wing Exit by Water Electric Room Photoelectric 30665198
0003 Smoke Detector 1 st B Wing Corridor By Daycare Room 5 Photoelectric 30665203
0004 Smoke Detector 1 st B Wing Corridor By Multi Purpose Photoelectric 30665204
Room
0005 Smoke Detector 1 st B Wing Corridor By Room14 Photoelectric 30665207
0006 Smoke Detector 1 st B Wing Outside Offices&Therapies Photoelectric 30665211
0007 Smoke Detector 1 st B Wing Social Workers Office 2 Photoelectric 30665217
0008 Smoke Detector 1 st B Wing Therapy Room Photoelectric 30665218
0011 Smoke Detector 1 st B Wing Corridor By Classroom 15 Photoelectric 30665259
0012 Smoke Detector 1 st B Wing Corridor By Office 6 Photoelectric 30665257
0014 Smoke Detector 1 st B Wing Corridor By 13 Photoelectric 30665251
0015 Smoke Detector 1 st B Wing Corridor Outside Mechanical Photoelectric 30665249
Room
0017 Smoke Detector 1st B Wing Inside Classroom S-4 Photoelectric 30665260
0018 Smoke Detector 1 st B Wing Inside Classroom S-5 Photoelectric 30665253
0019 Smoke Detector 1 st B Wing Inside Speech Pathology Photoelectric 30665250
0020 Smoke Detector 1 st B Wing Inside Classroom 16 Photoelectric 30665200
0021 Smoke Detector 1 st B Wing Inside Classroom 17 Photoelectric 30665208
0022 Smoke Detector 1 st B Wing Inside Classroom 18 Photoelectric 30665210
0023 Smoke Detector 1st B Wing Inside Sprinkler Room 19 Photoelectric 30665216
0024 Smoke Detector 1 st B Wing Inside Mechanical Room Photoelectric 36066531
0025 Smoke Detector 1 st B Wing Office 1 Photoelectric 30665243
0026 Smoke Detector 1 st B Wing Office 6 Photoelectric 30665254
0027 Smoke Detector 1st B Wing Office 5 Photoelectric 30665258
0028 Smoke Detector 1 st B Wing Inside 4 Photoelectric 30665262
0029 Smoke Detector 1 st B Wing Storage Room#6 Photoelectric 36066532
0030 Smoke Detector 1 st B Wing care Room 5 Photoelectric 30665202
0031 Smoke Detector 1 st B Wing Storage Room 8 Photoelectric 30665206
0043 Smoke Detector 1st B Wing Inside Nurse Office 7 Photoelectric 30665205
0063 Smoke Detector 1 st C Wing Inside Care Room 3 Photoelectric 30665320
0064 Smoke Detector 1 st C Wing Inside Classroom 9 Photoelectric 30665319
0068 Smoke Detector 1 st C Wing Inside Office 9 Photoelectric 30665324
0069 Smoke Detector 1 st C Wing Inside Office 8 Photoelectric 30665325
0070 Smoke Detector 1 st C Wing Inside Office 7 Photoelectric 30665326
ADT Commercial LLC 17 Download Date: 11/09/2022
0071 Smoke Detector 1 st C Wing Inside Classroom 8 Photoelectric 30665327
0072 Smoke Detector 1 st Hallway Corridor Outside Classroom Photoelectric 30665332
8
0073 Smoke Detector 1 st C Wing Inside Classroom 7 Photoelectric 30665328
0074 Smoke Detector 1 st C Wing Positioning Room 6A Photoelectric 30665329
0075 Smoke Detector 1 st C Wing Inside Classroom 6 Photoelectric 30665330
0076 Smoke Detector 1 st C Wing Inside Classroom 5 Photoelectric 30665334
0077 Smoke Detector 1 st C Wing Corridor Outside Classroom Photoelectric 30665331
5
0083 Smoke Detector 1 st C Wing OUTSIDE BOILER ROOM Photoelectric 30665281
0084 Smoke Detector 1 st C Wing Inside Classroom 4 Photoelectric 30665339
0085 Smoke Detector 1 st C Wing Care Room 2 Photoelectric 30665340
0086 Smoke Detector 1 st C Wing Corridor Outside Classroom Photoelectric 30665343
4
0088 Smoke Detector 1 st C Wing Inside Classroom 3 Photoelectric 30665344
0089 Smoke Detector 1 st C Wing Inside IT Office Photoelectric 30665346
0090 Smoke Detector 1 st C Wing Inside Financial 6 Photoelectric 30665347
0091 Smoke Detector 1 st C Wing Inside Nurses office 1 Photoelectric 30665348
0092 Smoke Detector 1 st C Wing Inside Financial 5 Photoelectric 30665345
0093 Smoke Detector 1 st C Wing Inside office 4 Photoelectric 30665349
0094 Smoke Detector 1 st C Wing Inside Janitors Closet 1 Photoelectric 30665350
0095 Smoke Detector 1 st C Wing Care Room 1 Photoelectric 30665352
0096 Smoke Detector 1 st C Wing Inside Classroom 2 Photoelectric 30665353
0097 Smoke Detector 1 st C Wing Inside Classroom 1 Photoelectric 30665354
0098 Smoke Detector 1 st A Wing ceiling hallway Corridor Photoelectric 30665358
outside bathroom 3
0099 Smoke Detector 1 st C Wing Corridor Outside Classroom Photoelectric 30665357
1
0102 Smoke Detector 1 st C Wing By Main Entrance Photoelectric 30665283
0103 Smoke Detector 1 st C Wing Directors Office Conference Photoelectric 30665359
Room
0106 Smoke Detector 1 st C Wing Corridor Reception Area Photoelectric 30665362
0107 Smoke Detector 1 st C Wing Outside Office 4 Photoelectric 30665282
0109 Smoke Detector 1 st C Wing Inside Office 1 Photoelectric 30665363
0110 Smoke Detector 1 st C Wing Inside Office 2 Photoelectric 30665364
0111 Smoke Detector 1 st C Wing Inside Financial Office 3 Photoelectric 30665351
0118 Duct Detector 1 st C Wing Fan Room A/C 4 Gym Photoelectric 36066540
0119 Duct Detector 1 st C Wing Fan Room A/C 3 Gym Photoelectric 36066541
0123 Smoke Detector 1 st C Wing Outside Office 9 Photoelectric 30665279
0124 Smoke Detector 1 st C Wing Outside Office 6A Photoelectric 30665280
0126 Pull Station 1 st Cleaner Storage Room Single Action 30665264
0127 Pull Station 1 st B Wing Exit By Water Electrical Room Single Action 30665199
0128 Pull Station 1 st B Wing Exit By Office Offices& Single Action 30665212
Therapies
0129 Pull Station 1st B Wing office&therapy side exit Single Action 30665219
0130 Pull Station 1st B Wing Main Entry Office&Therapies Single Action 30665213
0131 Pull Station 1 st B Wing Exit By Classroom 13 Single Action 30665248
0133 Tamper Switch 1 st B Wing Inside Sprinkler Room/ Room 36066555
19
0134 Tamper Switch 1 st B Wing Inside Sprinkler Room/ Room 36066129
19
0135 Waterflow Switch 1 st B Wing Inside Sprinkler Room/ Room 360661 35
19
ADT Commercial LLC 18 Download Date: 11/09/2022
0136 Tamper Switch 1 st B Wing Inside Sprinkler Room/ Room 34468783
19
0141 Pull Station 1 st C Wing Outside Exploring Nature Single Action 30665341
Office
0142 Pull Station 1 st C Wing Main entrance Single Action 30665361
0144 Power Supply 1 st Electrical Room 30665256
I
Zone/Circuit: 03
0001 Smoke Detector 1 st B Wing Inside Maintenance Office Photoelectric 30665295
0002 Smoke Detector 1 st A Wing Inside Tech Center Photoelectric 30665231
0017 Duct Detector 1 st B Wing Mechanical Room Photoelectric 36244866
0018 Smoke Detector 1 st B Wing Corridor Outside Maintenance Photoelectric 360661 27
Office
0019 Smoke Detector 1 st A Wing Corridor Outside Room 18 Photoelectric 30665242
0020 Smoke Detector 1 st A Wing Inside Classroom 14 Photoelectric 30665240
0021 Smoke Detector 1 st A Wing Inside Classroom 18 Photoelectric 30665241
0022 Smoke Detector 1 st A Wing Inside Classroom 17 Photoelectric 30665238
0023 Smoke Detector 1 st A Wing Corridor By Room 17 Photoelectric 30665239
0024 Smoke Detector 1 st A Wing Inside Classroom 16 Photoelectric 30665237
0025 Smoke Detector 1 st A Wing Inside Classroom 15 Photoelectric 30665235
0026 Smoke Detector 1 st A Wing Recreation Office Photoelectric 30665236
0027 Smoke Detector 1 st Inside Nurses Offiice Photoelectric 30665234
0028 Smoke Detector 1 st A Wing Corridor By Mechanical Room Photoelectric 30665233
0029 Duct Detector 1 st A Wing Mechanical Room A/C 5 Photoelectric 360661 33
0030 Smoke Detector 1 st A Wing Corridor Outside Bathroom Photoelectric 30665232
19
0031 Smoke Detector 1 st A Wing Corridor By School Kitchen Photoelectric 30665230
0032 Smoke Detector 1 st A Wing Cafeteria Photoelectric 30665228
0033 Smoke Detector 1 st A Wing OT/PT Offiice Photoelectric 30665226
0034 Smoke Detector 1 st A Wing Inside Workshop Area Photoelectric 30665229
0035 Smoke Detector 1 st A Wing Inside Workshop Area Photoelectric 30665227
0036 Smoke Detector 1 st A Wing Inside Workshop Area Photoelectric 30665225
0037 Smoke Detector 1 st A Wing Inside Workshop Area Photoelectric 30665224
Cypress Room
0038 Smoke Detector 1 st A Wing Inside Workshop Area Photoelectric 30665222
0039 Smoke Detector 1 st A Wing Inside Workshop Area Photoelectric 30665223
Cypress Room
0040 Smoke Detector 1 st A Wing Inside Workshop Area Near Photoelectric 30665221
Exit
0041 Smoke Detector 1 st C Wing Inside Gymnasium Area Photoelectric 36066535
0042 Smoke Detector 1 st C Wing Inside Gymnasium Area Photoelectric 36066536
0043 Smoke Detector 1 st C Wing Inside Gymnasium Area Photoelectric 36066537
0044 Smoke Detector 1 st C Wing Inside Gymnasium Area Photoelectric 36066538
0046 Smoke Detector 1 st C Wing Outside Supply Closet Photoelectric 30665274
0047 Smoke Detector 1 st C Wing Inside Supply Closet Photoelectric 30665275
0048 Smoke Detector 1 st C Wing Outside janitors Closet 2 Photoelectric 30665276
0049 Smoke Detector 1 st C Wing Inside Janitors Closet 2 Photoelectric 30665299
0052 Smoke Detector 1 st C Wing Inside Classroom 12 Photoelectric 30665307
0053 Smoke Detector 1 st C Wing Corridor Outside Classroom Photoelectric 30665277
12
0054 Smoke Detector 1 st C Wing Inside Classroom 1 1 Photoelectric 30665308
0055 Smoke Detector 1 st C Wing Inside Records Office Photoelectric 30665312
0056 Smoke Detector 1 st C Wing Inside Personal Care Room 4 Photoelectric 30665313
0058 Smoke Detector 1 st C Wing Inside Nursing Office 2 Photoelectric 30665314
ADT Commercial LLC 19 Download Date: 11/09/2022
0059 Smoke Detector 1 st C Wing Inside Office 10 Photoelectric 30665315
0060 Smoke Detector 1 st C Wing Inside Classroom 10 Photoelectric 30665316
0061 Smoke Detector 1 st C Wing Corridor Outside Classroom Photoelectric 30665333
10
0065 Heat Detector 1 st Conference Room Fixed Temperature 30665321
0080 Duct Detector 1 st C Wing Boiler Room Photoelectric 36066128
0112 Smoke Detector 1 st C Wing Inside Office 11 Photoelectric 30665311
0113 Smoke Detector 1 st C Wing Inside Office 12 Photoelectric 30665310
0114 Smoke Detector 1 st C Wing Inside Office 13 Photoelectric 30665309
0115 Smoke Detector 1 st GYMNASIUM storage 1 Photoelectric 30665271
0116 Smoke Detector 1 st Gym storage 2 Photoelectric 30665372
0117 Smoke Detector 1 st Gym storage 3 Photoelectric 30665373
0120 Smoke Detector 1 st C Wing Inside Fan Room Photoelectric 36244865
0121 Smoke Detector 1 st C Wing Outside Office 11 Photoelectric 30665278
0122 Smoke Detector 1 st C Wing Corridor 0/5 Staff Lounge Photoelectric 30665273
0132 Pull Station 1 st A Wing Staff Lounge Single Action 36066136
0133 Pull Station 1 st A Wing Workshop Exit Single Action 30665220
0134 Pull Station 1 st B Wing Outside Bathroom 8 Single Action 34468784
0135 Pull Station 1 st C Wing Outside Supply Closet Single Action 30665304
0136 Pull Station 1 st C Wing Gymnasium Entrance Single Action 30665302
0137 Pull Station 1 st C Wing Gym Entrance Single Action 30665301
0138 Pull Station 1 st C Wing Gym Rear Exit Left Single Action 30665300
0139 Pull Station 1 st C Wing Gym Rear Exit Right Single Action 30665303
0140 Pull Station 1 st C Wing Outside Care Room 3 Single Action 30665317
ADT Commercial LLC 20 Download Date: 11/09/2022
D EC ENE
BUILDING.DEPARTMENT 3D
VI LA C'E O RYE" ROOK NOV - 9 2022
938 KING ET RYE BRO�- NY 10573
-0 VILLAGE OF RYE BROOK
rg BUILDING DEPARTMENT
ly
FIRE INSPECTION / OPERATING PERMIT APPLICATION
FOR OFFICE USE ONLY:
Fee Paid: $ f�Q�J'� Inspection Date&Time: &0.147Ce
FEE SCHEDULE: Re-inspection Date& Time:
Triennial & Private School Annual Inspection: =$450.00
Public Assembly Annual Inspection: <100 People=$525.00/>100 People=$775.00
Application,dated: is hereby made to the Building Inspector of the Village of Rye Brook NY,requesting
that a Fire Inspection be conducted at the building and premises listed below for the purpose of issuing a Permit to Operate the business,
private school and/or place of public assembly in conformance with the Code of the Village of Rye Brook,the New York State Uniform
Fire Prevention & Building Code, Title 19 NYCRR Part 1201, and all other applicable local, County, State & Federal laws, rules &
regulations,as per detailed statement described below.
1. Address: 1186 King Street SBL: /3 j, y Zone:0i&—3
2. Business/Occupancy Name: Cerebral Palsy of Westchester NYS Use Class: A-3 Assembly
3. Property Owner: Address:
Phone# Cell# email:
5. Business Owner: Address:
Phone# Cell# email:
6. Emergency Contact: Dan Graham Address:
Phone# 914-937-3800 x407 Cell# 914-384-4060 email: Danny.graham@cpwestchester.org
7. Inspection Escort: nan C;raham Title: Maint. Supervisor
Phone#: Cell#: email:
8. Provide a brief description outlining the current and/or intended use of the property: School/Day Program
9. List all Hazardous Materials:
10. Occupant Load: Existing: Proposed: Other:
11. Date& Disposition of Previous Fire Inspection: 1/19/22 ® Pass ❑ Fail
8/12/2021
This application must include the notarized signature(s) of the legal owner(s) of
the above mentioned property, in the space provided below. Any application not
bearing the legal property owner's notarized signature(s) shall be deemed null
and void, and will be returned to the applicant.
**********************************************************************************************************
STATE OF NEW YORK
COUNTY OF WESTCHESTER as:
Linda Kuck
being duly sworn, deposes and states that he/she is the applicant above named,
(print name of individual signing application)
and further states that he/she is the legal owner of the property to which this application pertains,or that he/she is the
Executive Director , for the legal owner and is duly authorized to make and file this application. That all
(indicate architect,business owner,attorney,agent,etc.)
statements contained herein are true to the best of his/her knowledge and belief,and that any work perfonned or use conducted
at the above captioned property will be in conformance with the details as set forth and contained in this application and in any
accompanying approved plans and specifications,as well as in accordance with the New York State Uniform Fire Prevention
& Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances and regulations.
Sworn to before me this �` Sworn to bore me this
day of /VO✓2/Yh��.1� , 20 J day of /YU J eim {�—`✓ , 20
Notary Public Notary Public
x x c
III&AX4 —
ignature of Property Owner Signature of Applicant
Linda Kuck Linda Kuck
Print Name of Property Owner Print Name of Applicant
KAREN A TARANTO
KAREN A TARANTO NOta►Y Public,State of New York
Notary Public,State of New York No.01TA5014226
No.01TA5014226 Commission Expires
Qualified in Putnam County
7/15l20 d3
Qualified in Putnam County
Commission Expires V15120-3..3
8/12/2021